Signs And Symptoms Of Testicular Cancer

What’s covered?

Testes can be prone to cancer

Cancer develops when body cells start dividing out of control, resulting in a clump of cells called a 'tumour'. In the later stages of cancer, the cells spread to local lymph nodes and then to other body organs (metastasis). According to Cancer Research UK, cancer is responsible for more than 150,000 annual deaths in the United Kingdom.

What is testicular cancer?

Testes are the most important part of the male reproductive system. These small organs (a single testis weighing nearly 25 grams) produce billions of sperm (the germ cells fertilise the eggs). Besides the sperms, the testes also produce the important hormone testosterone that causes male characters.

Cancer can develop in your testes too. This is because the cells of the testes are rapidly dividing and are more prone to cancer. The testicular tumours are, however, rare, and according to Cancer Research UK, it is the 17th most important cancer with nearly 2,400 annual cases. It accounts for less than 1% of cancers of internal organs.

Why does cancer develop in the testes?

The testes are most sensitive to dangerous radiations, one of the important causes of cancers. Cancer is a very complex problem, and no single factor can be held responsible for it. However, the following factors are known to have a role in the development of testicular cancer. Controlling these factors will be important for testicular cancer treatment.

• The family history of testicular cancers

• If one or both of your testes are in the abdomen or were in the abdomen at the time of birth

• An abundance of abnormal cells in the testes (germ cell neoplasia in situ- GCNIS). These cells are the precursors of different testicular germ cell tumours.

If you have a history of exposure to these factors, it would be good to undergo a yearly testicular examination.

How to identify testicular tumours?

The testes (normally) are located outside the body, so testicular cancer is easily detected. You can note several important signs and symptoms if you have testicular cancer. However, all these signs are not specific to cancer and could be related to various other conditions too. Some of the important signs of testicular cancer are;

Visible lump or swelling

Like any other cancer, an enlarged mass in the testes or a hard area could be a sign of cancer. If you feel any such lump in the testes, go immediately to the doctor. Besides the testicular lumps, many symptoms can be noted depending upon the severity, degree and spread of the disease. Some other signs of testicular cancer are;

Painless lump or swelling

A painless swelling with a history of numbness and disciform in the testes should be viewed as from cancerous lesions.

Painful groin area

A later stage testicular cancer will cause your groin area to become painful. If you have a history of a dull ache in the groin area, a testicular tumour could be the cause. This pain will be persistent and doesn't respond to medications. Pain in the groin region means cancer has spread to lymph nodes or groin regions.

Growth of breast tissue

The growing and tender breasts are also important signs. This is because the hormonal secretions are disturbed due to cancer in the testes leading to large, tender and soft breasts. Why does this happen? Some germ cell tumours secrete an enzyme called human chorionic gonadotropin (HCG). This hormone increases the secretion of testosterone and also influences the breasts.

Size discrepancy of testes

Note any change in the consistency of testes. One of the testes may feel warmer, heavier and firmer than the other. The discrepancy in the size of testes usually reflects cancer in the heavier ones. A pea-sized hard lump in the testes could be felt.

Metastasis

In the later and advanced stages, the cancer cells can metastasise to other tissues. The spread to the respiratory system can cause symptoms, e.g., chest pain, blood in the sputum, shortened breaths etc... Metastasis is the spread of cancer to other tissue of the body. Similarly, the metastasis to other regions will produce according to symptoms.

The cancer cells will spread to other organs by travelling through the blood. This is a common finding in the advanced stage of cancer. Depending on the organs involved, you can note other signs and symptoms. For example, metastasis of the disease to other organs is found in 5% of people with testicular cancer.

Most commonly, these cells migrate to the local lymph nodes or lungs. Along with other issues, back pain, breathing issues and swelling in the neck can occur in metastatic cancer.

When should you consult a doctor?

The appearance of a lump in the testes which doesn't resolve should not be ignored, and you should rush to the hospital.

Keep in mind that a scrotal swelling could be due to various other causes, e.g., varicoceles (swollen blood vessels), cysts in the testicular cancer tubes etc...

The physician will thoroughly examine your testes and ask you to go through other tests, e.g., radiography, histopathology, retroperitoneal lymph node dissection (RPLND) etc..., to fully understand the nature of the tissue. After confirmation of cancer, you should start treatment as soon as possible for a better prognosis. The doctor can prescribe anti-cancer drugs or chemotherapy to kill cancer cells.

If you are exposed to the risk factors, it will be wise to visit your nearest sexual health clinic routinely.

Testicular self-examination (TSE)

Testes are highly prone to developing cancer, but the good news is that testicular cancer is also very treatable. A review published in the Journal of the National Cancer Institute found that it is highly treatable and noted a ten-year survival rate of 95%. It means 95% off become to develop this condition can enrol themselves as testicular cancer survivors.

Only you have to detect it at a basic stage. Testicular self-examination is very useful for identifying a tumour in the testes. Because your testes are normally located outside of the body (in the scrotum), you or your partner can most of the time find out the problem, and you will rarely need to visit the doctor. For your safety, it is recommended to examine your testes for at least only a month.

Why choose TSE?

What can a regular testicular self-exam do for you? Of course, the biggest benefit is that you develop a familiarity with your testes which help you to find out any abnormalities later on.

How is it done?

Have you noticed your testes in the summer? The scrotums have relaxed, and the testes feel hanging loosely. That's why, for a thorough examination, a warm water shower is recommended.

The procedure of TSE is as follows:

• Look for any abnormal bump in both testes and compare them. A difference in sizes is not so important as long as the testes are of normal shape.

• All testicular lumps are not due to cancer. You should know that the tested have a sperm duct called the epididymis. It appears as a small raised area on the upper side or in the middle of the outer side of the testes.

• Blood vessels are also present around the testes, which could be confused as cancerous bumps. Consult your doctor if you have any questions.

• Standing in front of a mirror can also help to find out any problem in the testes and scrotum.

• Hold both testes in both hands and roll them between your fingers.

• In each successive examination, look for any change in the testes' size, consistency, or shape.

• A normal test should be smooth and firm.

• A routine examination should be painless. Dull pain and heaviness should not be ignored and should be reported immediately to the doctor.

In case of enlarged testes, don't panic. It could be due to other causes, e.g., hydrocele, venous dilation etc...The physician will decide if your problem is due to these issues or cancer.

Bottom-line

Your testes are highly prone to cancer. You can develop testicular cancer at any age. Still, most cancers are diagnosed around 30. Depending upon the severity of the problem, you can note various signs and symptoms. It is important to self-examine your testes regularly so that any cancerous problem is caught before it is too late.

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